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Lewis and Clark: Doctors in the Wilderness

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If there is any event in American history that has been thoroughly documented it is the Lewis & Clark expedition, 1803-06.
Surprisingly, one area that has been generally overlooked is the medical aspect of the expedition. A retired cardiac surgeon and wilderness medical expert, Bruce C. Paton, has remedied that oversight with this fascinating book.
In a highly readable, non-techinal manner, Paton examines the state of medicine in 1800 and discusses the medical preparations made by Meriwether Lewis for the journey including, at the urging of President Jefferson, his meetings with leading scholars of the time.
The story of Lewis' meeting with Dr. Benjamin Rush, the advising physician to the expedition, is interesting not only for the advice given to Lewis but for Rush's varied interests and activities. Rush's list of 10 steps to follow in order to maintain the health of the expedition members provides the reader with a stark reminder of the state of medical care in early 1800.
In addition, the author discusses the diagnoses and treatment of three specific major medical crises that confronted the expedition: the gunshot wound suffered by Lewis, the illness of Sacagawea and the death of Sergeant Floyd. While the death of Floyd did not affect the ultimate success of the expedition, the author speculates on what the outcome might have been had Sacagawea or Lewis died. That they did survive may have been due more to luck than the treatment they received.
Only one member died during the incredible three-year ordeal despite limited medical knowledge and medications that were largely ineffective.
This is a must book for anyone remotely interested in the Lewis & Clark expedition. Highly recommended.

What I know about the medical field one could easily fit into a thimble but this book is a well written, entertaining and informative look into medical practices during the early 1800's. Dr. Paton's focus is on how Lewis and Clark dealt with the many medical mishaps on their nearly two and a half year expedition.
We read of early nineteenth century treatments for everything from fevers, frostbite, boils, hypothermia, smallpox, inflammations and snakebites to venereal disease and paralysis, along with comparisons to modern day medical science.
In addition to the above, Dr. Paton closely examines the symptoms and treatments of Sgt. Charles Floyd's illness up to his untimely death; investigates Sacagawea's ill health just prior to the Great Falls portage; the mysterious illnesses of Pvt. William Bratton and a Nez Perce Indian chief; and the accidental gunshot wound to Lewis. When the expedition was delayed during the return trip at the Nez Perce camps, Clark offered his medical care and attention to the Indians in exchange for food and horses.
This is an insightful, enjoyable and very readable account on how wilderness medicine was performed two hundred years ago.

Dr. Bruce Patton writes a highly readable book on the Lewis and Clark expedition zeroing in on the exposures the men and Indians had to various ailments and injuries with treatment lent by amateur physicians Lewis and Clark. Patton incorporates the various medical challenges the men faced while doing a top-notch job describing their adventure with excellent detail in this compact book. Patton describes Lewis' training with the eminent physician of his time Dr. Rush in a two-week internship in Philadelphia. This brief period of medical knowledge is framed by bleeding, purging of the bowels and little knowledge of germs and sanitation. In spite of limited training, L & C do a very commendable job treating the men and Indians by also combining good common sense and knowledge of frontier treatments. Patton describes in layman terms the various injuries and illnesses that the corps were facing from venomous snakebites, frostbite, boils, abscesses, lacerations, deep wounds, gunshot wounds (Lewis) gonorrhea, syphilis (treated with mercury), dislocations and various eye injuries. The latter treated with "eye water" that made them mysterious and gifted shaman in the eyes of many of the west of the Rockies Indians. Clark becomes the Nez Perce's favorite physician and Lewis steps aside as Clark's clinic earns supplies needed to survive the wait for the snows to melt. Patton also observes that Clark seemed to have a natural humanitarian interest in the Indians as exhibited by his concerns for the periodically ill Sacagawea and her child "Pompie" in contrast to Lewis' less charitable concerns. Clark's more sensitive spirit may have been apparent to the Nez Perce who made him their physician of choice. Patton also offers a diagnosis of the only casualty of the expedition, Sergeant Floyd who died early in the adventure. Thought to have died by appendicitis, Patton reviews the symptoms in the journal and offers a different opinion. Limited to the description of symptoms in journals, Patton systematically offers a diagnosis of what may have been troubling the ill individuals and then analyzes the treatment. Not quite as detailed as a similar book written by another physician ("Or Perish in the Attempt") the book serves as an equal companion and contrast. And actually reading both books is a joy as they do vary in areas and both are well written. Patton also offers an excellent history of the expedition that surprisingly offers noteworthy episodes not described in the book "Undaunted Courage" that focused more on Lewis. For example, Patton accurately describes the loss of horses by Sergeant Pryor, stolen by Crow Indians, after Pryor separated from Clark who stayed with the canoes. Patton describes how Pryor and company unexpectedly rejoins Clark's flotilla by ingeniously making 'bull boats', providing simple and a fast mode of transportation. A very pleasant read and Dr. Patton writes for the reader, medical layman and all, educating in a straight forward and understanding way. Well worth reading as a companion to a detailed account or if you have time for one book, you won't go wrong with Patton's book.

This book by Dr. Paton has to be essential to anyone interested
in the Lewis and Clark expedition, if for no other reason than
he addresses some issues not explored by anyone else.
He talks about the various illnesses and pains experienced by
Expedition members over the 2-1/2 years they were gone from
"civilization," and he combines knowledge of the historical
aspects of medicine of that day with how such problems could
be handled today.
This book should be read in conjunction with the more detailed
books, such as the Stephen Ambrose book or the 1-volume edited
version of the actual L&C journals themselves published by
the U. of Nebraska, so the medical problems can be more fully
understood in context with the overall trip.
In addition to the various ailments suffered by the members,
the author discusses why some problems were so great, and why
they persisted throughout the Expedition, and then how such
problems would be eliminated today. He talks about the very
serious matters that could have curtailed, or ended, the Expedition, which allows us to understand even more fully just
how great, and perhaps lucky, Lewis and Clark were to make such
a tremendous trip with only one death.
In addition, he points out that the leaders had to contend with
requests by local Indians for medical care and how they responded. Interestingly, L&C each responded with genuine
concern, and occasionally some tenderness, toward the Indians
they met who need medical attention. Both men helped all the
Indians they could, dispensing their limited medical supplies
as needed, showing a concern that would be unmatched by later
Europeans dealing with Indians.
Of some interest also is that the Indians of the Rockies very
quickly tended to favor Clark when seeking medical help, revealing that he had the superior "bedside manner" when dealing
with those Native Americans. Clark's interest and concern was
later reflected in his long service as Indian Commissioner for
the new territory, and he always tried to obtain favorable treatment for the Indians of the Louisiana Purchase from the
government, and he used his best ability to try to make the
government keep its word to those Indians.
Dr. Paton describes the effects of dirty drinking water, unsanitary camp conditions, snake bite, nettles, the extrememly
hard labor required during the long days, as well as the problems facing the Expedition when their normal food supplies
ran out.
This is a very significant addition to our knowledge of what Lewis and Clark, and their men, faced during that arduous trek
to the Pacific and back during 1804-1806. Plus, it is very
interesting reading, and it should be read by everyone interested in early U.S. history.

Very interesting info re: Doctors in the day of Lewis and Clark. The author being an MD gives the book it's authentic flavor. Great read.

Excellent. It takes the Ambrose descriptions of the Voyage of Discovery to a new level with medical information. Funny, in places, highly recommended

Dr. Paton writes in a readable way of the L&C expedition and the medical supplies they took, treatments, and diseases and injuries they encountered. It is balanced so you don't read more of the expedition or the medical parts than you want. If the reader knows nothing of the expedition, this is a good way to become acquainted. I must be honest, I skipped the first chapter, "Setting the Scene" because I've already done some L&C reading. I thought the last chapter was the best in the book, "Afterthoughts," in which Dr. Paton reflects on the enormity of L&C's achievement and compares it to what a modern effort of this level would entail.